Key result
Left axillary artery cannulation facilitates reoperative total aortic arch replacement by enabling cardiopulmonary bypass before sternal re-entry and reducing the risk of embolic complications.
Case Report
Left axillary artery cannulation is a practical surgical strategy that facilitates cardiopulmonary bypass and reduces embolic risks during complex reoperative total aortic arch replacements.
Answers are grounded in this paper and cite their sources.
May facilitate reoperative total arch replacement via left axillary cannulation; leaves open need for validation in larger cohorts.
Total aortic arch replacement remains a technically formidable procedure, particularly in patients with previous proximal aortic dissection repair. Our case discussion highlights a useful strategy for extracorporeal support and circulation management to facilitate total arch reconstruction in the reoperative setting, based on cannulation of the left axillary artery. Our preference is to use a left axillary artery approach to initiate cardiopulmonary bypass and to ultimately revascularize the left arm via an extra-anatomic graft. Our technique, as described, affords the option to initiate cardiopulmonary bypass before sternal re-entry, it reduces the risk of embolic complications and possible stroke, and it directly facilitates simple extra-anatomic debranching of the left subclavian artery, resulting in easier arch and great vessel reconstruction within the chest.
No takes yet. Share an insight, caveat, or question.
Hemli et al. (2018) conducted a case report in Reoperative total aortic arch replacement. Left axillary artery cannulation was evaluated. Left axillary artery cannulation facilitates reoperative total aortic arch replacement by enabling cardiopulmonary bypass before sternal re-entry and reducing the risk of embolic complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: